Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.
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- Food‐induced fatal anaphylaxis: from epidemiologic...
- “So … who is your audience?”
- The division of cognitive labor: two missing dimen...
- Predictors of Therapeutic Outcome to Nucleotide Re...
- Classification of lesions inducing acquired choles...
- Bacteriology of peritonsillar abscess: the changin...
- Histopathological comparison of bone healing effec...
- Endoscopic observation of different repair pattern...
- Familial misophonia or selective sound sensitivity...
- Is there a best side for cochlear implants in post...
- Prognostic significance of soft tissue deposits in...
- Audiological and electrophysiological alterations ...
- Psychoacoustic classification of persistent tinnitus
- Disease‐specific quality of life after septoplasty...
- Association of Ugrp2 gene polymorphisms with adeno...
- Effects of cavity reconstruction on morbidity and ...
- Temporomandibular disorder: otologic implications ...
- Multidimensional effects of voice therapy in patie...
- Retro‐ and orthonasal olfactory function in relati...
- Diagnostic validity of methods for assessment of s...
- The use of tDCS as a therapeutic option for tinnit...
- Transoral robotic supraglottic partial laryngectom...
- Bilateral primary histiocytoid eccrine sweat gland...
- Stafne bone cavity containing ectopic parotid gland
- Thyroid® High-Impact Articles
- Real-Time Measurement of Xenon Concentration in a ...
- Predicting the Size of a Left Double-Lumen Tube fo...
- Regional Anesthesia and Readmission Rates After To...
- Predosing Chemical Stability of Admixtures of Prop...
- Resident Competency and Proficiency in Combined Sp...
- Red Blood Cell Transfusion in Pediatric Orthotopic...
- Statistical Versus Clinical Significance in Subcla...
- Lupin: An Emerging Food Allergen in the United States
- Sensitization Profiles to Hazelnut Allergens acros...
- Level of competence of primary and secondary schoo...
- Use of disposable blade for harvesting epidermal s...
- Late growth of infantile hemangiomas in children >...
- Two facets of sweat: A defensive factor in skin ti...
- Congenital cytomegalovirus infection inducing non-...
- Neurologically Acquired Laryngomalacia in a Pediat...
- Urine concentrations changes of cysteinyl leukotri...
- Trends in Sociodemographic Disparities of Pediatri...
- Corrigendum to 'Epidemiological characteristics of...
- Identification of Baseline Factors Associated With...
- The Role of Otolaryngologists in Eradicating Human...
- Cognitive Behavioral Therapy for Tinnitus Unbound
- The Role of Otolaryngologists in Eradicating Human...
- Effectiveness of Internet Cognitive Behavioral The...
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- The Economics of Higher Education
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- Enhancing Behavior Change Technique Coding Methods...
- A direct method for the N-tetraalkylation of azama...
- LUBAC prevents lethal dermatitis by inhibiting cel...
- Data for "Low-noise 1.3 μm InAs/GaAs quantum dot l...
- Stafne bone cavity containing ectopic parotid gland
- Effects of cavity reconstruction on morbidity and ...
- Association of Ugrp2 gene polymorphisms with adeno...
- Disease-specific quality of life after septoplasty...
- Psychoacoustic classification of persistent tinnitus
- Audiological and electrophysiological alterations ...
- Prognostic significance of soft tissue deposits in...
- Is there a best side for cochlear implants in post...
- Familial misophonia or selective sound sensitivity...
- Endoscopic observation of different repair pattern...
- Histopathological comparison of bone healing effec...
- Bacteriology of peritonsillar abscess: the changin...
- Bilateral primary histiocytoid eccrine sweat gland...
- Retro- and orthonasal olfactory function in relati...
- Multidimensional effects of voice therapy in patie...
- Temporomandibular disorder: otologic implications ...
- Transoral robotic supraglottic partial laryngectom...
- Laryngeal inflammatory response to smoke and vape ...
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- Hypopharyngeal cancer: A state of the art review
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Ετικέτες
Πέμπτη 4 Οκτωβρίου 2018
Food‐induced fatal anaphylaxis: from epidemiological data to general prevention strategies
“So … who is your audience?”
Abstract
To whom, if anyone, are the writings of philosophers of science relevant? There are three potential groups of people: Philosophers, Scientists, and Interested Citizens, within and beyond the academy. I argue that our discipline is potentially relevant to all three, but I particularly press the claims of the Interested Citizens. My essay is in dialogue with a characteristically insightful lecture given thirty years ago by Arthur Fine. Addressing the Philosophy of Science Association as its president, Fine argued that general philosophy of science was dead, and that all the action lay in the philosophy of the special sciences. I try to identify what was correct about Fine's diagnosis, while supplementing his message by describing fruitful projects that have since emerged. I also hope to share his subversive spirit.
https://ift.tt/2OC436V
The division of cognitive labor: two missing dimensions of the debate
Abstract
The question of the division of cognitive labor (DCL) has given rise to various models characterizing the way scientists should distribute their efforts. These models often consider the scientific community as a self-governed sphere constituted by rational agents making choices on the basis of fixed rules. Such models have recently been criticized for not taking into account the real mechanisms of science funding. Hence, the question of the utility of the DCL models in guiding science policy remains an open one. In this paper, we show that two unconsidered dimensions would have to be taken into account. First, DCL studies miss the existence of distinct levels of epistemic objectives organizing the research process. Indeed, the scientific field is structured as a system of hierarchical, interconnected practices which are defined both by their inherent purposes and by various superposed external functions. Second, I criticize the absence of ontological considerations, since the epistemological significance of pluralism is highly dependent on the nature of the object under study. Because of these missing dimensions, current DCL models might have a limited usefulness to identify good practices of research governance.
https://ift.tt/2NoU0xq
Predictors of Therapeutic Outcome to Nucleotide Reverse Transcriptase Inhibitor in Hepatitis B Patients
Viral Immunology, Ahead of Print.
https://ift.tt/2CrWPNs
Classification of lesions inducing acquired cholesteatomas of the middle ear: a didactic suggestion
Fernando de Andrade Quintanilha Ribeiro
Braz J Otorhinolaryngol.2018;84:529-31
Texto Completo - PDF
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Bacteriology of peritonsillar abscess: the changing trend and predisposing factors
Yi‐Wen Tsai, Yu‐Hsi Liu, Hsing‐Hao Su
Braz J Otorhinolaryngol.2018;84:532-9
Resume - Texto Completo - PDF
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Histopathological comparison of bone healing effects of endonasal and percutaneous lateral osteotomy methods in rabbit rhinoplasty model
Şahin Öğreden, Sedat Rüzgar, Hasan Deniz Tansuker, Ümit Taşkın, Yalçın Alimoğlu, Salih Aydın, Mehmet Faruk Oktay, Uğur İzol
Braz J Otorhinolaryngol.2018;84:540-4
Resume - Texto Completo - PDF
https://ift.tt/2P7NOeW
Endoscopic observation of different repair patterns in human traumatic tympanic membrane perforations
Peng Huang, Shujun Zhang, Xinhong Gong, Xuesong Wang, Zi‐Han Lou
Braz J Otorhinolaryngol.2018;84:545-52
Resume - Texto Completo - PDF
https://ift.tt/2y1oCAd
Familial misophonia or selective sound sensitivity syndrome: evidence for autosomal dominant inheritance?
Tanit Ganz Sanchez, Fúlvia Eduarda da Silva
Braz J Otorhinolaryngol.2018;84:553-9
Resume - Texto Completo - PDF
https://ift.tt/2PbuRIn
Is there a best side for cochlear implants in post‐lingual patients?
Maria Stella Arantes do Amaral, Thiago A. Damico, Alina S. Gonçales, Ana C.M.B. Reis, Myriam de Lima Isaac, Eduardo T. Massuda, Miguel Angelo Hyppolito
Braz J Otorhinolaryngol.2018;84:560-5
Resume - Texto Completo - PDF
https://ift.tt/2xWM95m
Prognostic significance of soft tissue deposits in laryngeal carcinoma
Omer Afsin Ozmen, Melih Alpay, Ozlem Saraydaroglu, Uygar Levent Demir, Fikret Kasapoglu, Hamdi Hakan Coskun, Oguz Ibrahim Basut
Braz J Otorhinolaryngol.2018;84:566-73
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https://ift.tt/2P7NNYq
Audiological and electrophysiological alterations in HIV‐infected individuals subjected or not to antiretroviral therapy
Carla Gentile Matas, Alessandra Giannella Samelli, Fernanda Cristina Leite Magliaro, Aluisio Segurado
Braz J Otorhinolaryngol.2018;84:574-82
Resume - Texto Completo - PDF
https://ift.tt/2xYVbyQ
Psychoacoustic classification of persistent tinnitus
Flavia Alencar de Barros Suzuki, Fabio Akira Suzuki, Ektor Tsuneo Onishi, Norma Oliveira Penido
Braz J Otorhinolaryngol.2018;84:583-90
Resume - Texto Completo - PDF
https://ift.tt/2PdfvmL
Disease‐specific quality of life after septoplasty and bilateral inferior turbinate outfracture in patients with nasal obstruction
Lucas Resende, Carolina do Carmo, Leão Mocellin, Rogério Pasinato, Marcos Mocellin
Braz J Otorhinolaryngol.2018;84:591-8
Resume - Texto Completo - PDF
https://ift.tt/2xWM5CE
Association of Ugrp2 gene polymorphisms with adenoid hypertrophy in the pediatric population
Mahmut Huntürk Atilla, Sibel Özdaş, Talih Özdaş, Sibel Baştimur, Sami Engin Muz, Işılay Öz, Kenan Kurt, Afife İzbirak, Mehmet Ali Babademez, Nilgün Vatandaş
Braz J Otorhinolaryngol.2018;84:599-607
Resume - Texto Completo - PDF
https://ift.tt/2PbPaW9
Effects of cavity reconstruction on morbidity and quality of life after canal wall down tympanomastoidectomy
Sinan Uluyol, Omer Ugur, Ilker Burak Arslan, Ozlem Yagiz, Murat Gumussoy, Ibrahim Cukurova
Braz J Otorhinolaryngol.2018;84:608-13
Resume - Texto Completo - PDF
https://ift.tt/2xWM1Tq
Temporomandibular disorder: otologic implications and its relationship to sleep bruxism
Bruno Gama Magalhães, Jaciel Leandro de Melo Freitas, André Cavalcanti da Silva Barbosa, Maria Cecília Scheidegger Neves Gueiros, Simone Guimarães Farias Gomes, Aronita Rosenblatt, Arnaldo de França Caldas Júnior
Braz J Otorhinolaryngol.2018;84:614-9
Resume - Texto Completo - PDF
https://ift.tt/2PbP4Oh
Multidimensional effects of voice therapy in patients affected by unilateral vocal fold paralysis due to cancer
Camila Barbosa Barcelos, Paula Angélica Lorenzon Silveira, Renata Lígia Vieira Guedes, Aline Nogueira Gonçalves, Luciana Dall'Agnol Siqueira Slobodticov, Elisabete Carrara‐de Angelis
Braz J Otorhinolaryngol.2018;84:620-9
Resume - Texto Completo - PDF
https://ift.tt/2y1BiXX
Retro‐ and orthonasal olfactory function in relation to olfactory bulb volume in patients with hypogonadotrophic hypogonadism
Murat Salihoglu, Onuralp Kurt, Seyid Ahmet Ay, Kamil Baskoy, Aytug Altundag, Muzaffer Saglam, Ferhat Deniz, Hakan Tekeli, Arif Yonem, Thomas Hummel
Braz J Otorhinolaryngol.2018;84:630-7
Resume - Texto Completo - PDF
https://ift.tt/2PdsbtJ
Diagnostic validity of methods for assessment of swallowing sounds: a systematic review
Karinna Veríssimo Meira Taveira, Rosane Sampaio Santos, Bianca Lopes Cavalcante de Leão, José Stechman Neto, Leandro Pernambuco, Letícia Korb da Silva, Graziela De Luca Canto, André Luís Porporatti
Braz J Otorhinolaryngol.2018;84:638-52
Resume - Texto Completo - PDF
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The use of tDCS as a therapeutic option for tinnitus: a systematic review
Amanda dos Humildes Maia Santos, Afonso Paranhos Silva Santos, Henrique Souza Santos, Adriana Campos da Silva
Braz J Otorhinolaryngol.2018;84:653-9
Resume - Texto Completo - PDF
https://ift.tt/2PcGMpo
Transoral robotic supraglottic partial laryngectomy: report of the first Brazilian case
Claudio Roberto Cernea, Leandro Luongo Matos, Dorival de Carlucci Junior, Fernando Danelon Leonhardt, Leonardo Haddad, Fernando Walder
Braz J Otorhinolaryngol.2018;84:660-4
Texto Completo - PDF
https://ift.tt/2xZZt98
Bilateral primary histiocytoid eccrine sweat gland carcinoma of eyelids
Malgorzata Seredyka‐Burduk, Pawel Krzysztof Burduk, Magdalena Bodnar, Grazyna Malukiewicz, Andrzej Kopczynski
Braz J Otorhinolaryngol.2018;84:665-8
Texto Completo - PDF
https://ift.tt/2PjByba
Stafne bone cavity containing ectopic parotid gland
Mesut Kaya, Kadriye Serife Ugur, Elif Dagli, Hanifi Kurtaran, Mehmet Gunduz
Braz J Otorhinolaryngol.2018;84:669-72
Texto Completo - PDF
https://ift.tt/2y3j20f
Thyroid® High-Impact Articles
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Latest Impact Factor: 7.557
The Official Journal of: American Thyroid Association®
Incidences of Unfavorable Events in the Management of Low-Risk Papillary Microcarcinoma of the Thyroid by Active Surveillance Versus Immediate Surgery
Hitomi Oda, Akira Miyauchi, Yasuhiro Ito, Kana Yoshioka, Ayako Nakayama, Hisanori Sasai, Hiroo Masuoka, Tomonori Yabuta, Mitsuhiro Fukushima, Takuya Higashiyama, Minoru Kihara, Kaoru Kobayashi, and Akihiro Miya
A Clinical Framework to Facilitate Risk Stratification When Considering an Active Surveillance Alternative to Immediate Biopsy and Surgery in Papillary Microcarcinoma
Juan P. Brito, Yasuhiro Ito, Akira Miyauchi, and R. Michael Tuttle
Subclinical Hypothyroidism in Pregnancy: A Systematic Review and Meta-Analysis
Spyridoula Maraka, Naykky M. Singh Ospina, Derek T. O'Keeffe, Ana E. Espinosa De Ycaza, Michael R. Gionfriddo, Patricia J. Erwin, Charles C. Coddington III, Marius N. Stan, M. Hassan Murad, and Victor M. Montori
Preoperative Cytologic Diagnosis of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: A Prospective Analysis
Kyle C. Strickland, Marina Vivero, Vickie Y. Jo, Alarice C. Lowe, Monica Hollowell, Xiaohua Qian, Tad J. Wieczorek, Christopher A. French, Lisa A. Teot, Peter M. Sadow, Erik K. Alexander, Edmund S. Cibas, Justine A. Barletta, and Jeffrey F. Krane
An International Multi-Institutional Validation of Age 55 Years as a Cutoff for Risk Stratification in the AJCC/UICC Staging System for Well-Differentiated Thyroid Cancer
Iain J. Nixon, Laura Y. Wang, Jocelyn C. Migliacci, Antoine Eskander, Michael J. Campbell, Ahmad Aniss, Lilah Morris, Fernanda Vaisman, Rossana Corbo, Denise Momesso, Mario Vaisman, Andre Carvalho, Diana Learoyd, William D. Leslie, Richard W. Nason, Deborah Kuk, Volkert Wreesmann, Luc Morris, Frank L. Palmer, Ian Ganly, Snehal G. Patel, Bhuvanesh Singh, R. Michael Tuttle, Ashok R. Shaha, Mithat Gönen, K. Alok Pathak, Wen T. Shen, Mark Sywak, Luis Kowalski, Jeremy Freeman, Nancy Perrier, and Jatin P. Shah
Noninvasive Follicular Variant of Papillary Thyroid Carcinoma and the Afirma Gene-Expression Classifier
Kristine S. Wong, Trevor E. Angell, Kyle C. Strickland, Erik K. Alexander, Edmund S. Cibas, Jeffrey F. Krane, and Justine A. Barletta
Clinical and Pathologic Predictors of Lymph Node Metastasis and Recurrence in Papillary Thyroid Microcarcinoma
Saaduddin Siddiqui, Michael G. White, Tatjana Antic, Raymon H. Grogan, Peter Angelos, Edwin L. Kaplan, and Nicole A. Cipriani
The 2017 Bethesda System for Reporting Thyroid Cytopathology
Edmund S. Cibas and Syed Z. Ali
The post <i>Thyroid<sup>®</sup></i> High-Impact Articles appeared first on American Thyroid Association.
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Real-Time Measurement of Xenon Concentration in a Binary Gas Mixture Using a Modified Ultrasonic Time-of-Flight Anesthesia Gas Flowmeter: A Technical Feasibility Study
https://ift.tt/2IBXaNw
Predicting the Size of a Left Double-Lumen Tube for Asian Women Based on the Combination of the Diameters of the Cricoid Ring and Left Main Bronchus: A Randomized, Prospective, Controlled Trial
https://ift.tt/2pCC0X0
Regional Anesthesia and Readmission Rates After Total Knee Arthroplasty
https://ift.tt/2pCiBFw
Predosing Chemical Stability of Admixtures of Propofol, Ketamine, Fentanyl, and Remifentanil
https://ift.tt/2pA6xoh
Resident Competency and Proficiency in Combined Spinal–Epidural Catheter Placement Is Improved Using a Computer-Enhanced Visual Learning Program: A Randomized Controlled Trial
https://ift.tt/2IBOkiR
Red Blood Cell Transfusion in Pediatric Orthotopic Liver Transplantation: What a Difference a Few Decades Make
https://ift.tt/2pCx3NW
Statistical Versus Clinical Significance in Subclavian Vein Cross-Sectional Area: Is a 0.10-cm2 Difference Really Meaningful or Just an Example of False Precision?
Lupin: An Emerging Food Allergen in the United States
Food allergies are on the rise and becoming a global concern.1 Common food allergens are well recognized and have been studied extensively in the US and Europe. However, there is a gradual emergence of new food allergens such as lupin, which are neither as well characterized nor studied.
https://ift.tt/2CvHds6
Sensitization Profiles to Hazelnut Allergens across the United States of America
Hazelnut is a widely consumed tree nut and among the top five most serious instigators of food allergic reactions.1-4 Hazelnut allergy can manifest symptoms that range from mild oral itching to fatal anaphylaxis.4-7 Population-based surveys have found that the incidence of hazelnut allergy varies greatly from location to location, depending on exposure to cross-reacting pollen allergens.8-10 The prevalence of hazelnut allergy is estimated to be 0.2 % in children and up to 4.5 % in adults in regions with heavy exposure to pollen of birch or related tree species.
https://ift.tt/2BUX6ai
Level of competence of primary and secondary school teachers in the management of anaphylaxis
Anaphylaxis is a severe hypersensitivity reaction, with the highest incidence in early childhood.1 It can lead to respiratory arrest, so early detection and immediate reaction is needed.2 However, this is not always simple, as most of the reactions occur far from hospitals, for example, at school.3 Since children spend much of their time in school, teachers should know how to identify and manage these situations. In Spain, training programmes aimed at teachers for the management of anaphylactic reactions, such as the "School Alert (Alerta Escolar) Program",4 have been developed.
https://ift.tt/2CrYliu
Late growth of infantile hemangiomas in children >3 years of age: A retrospective study
The proliferative phase of infantile hemangiomas (IHs) is usually complete by 9 months of life. Late growth beyond age 3 years is rarely reported.
https://ift.tt/2PajzE5
Two facets of sweat: A defensive factor in skin tissues and an accelerating factor for allergic skin diseases
Publication date: October 2018
Source: Allergology International, Volume 67, Issue 4
Author(s): Hiroo Yokozeki, Kenji Izuhara
https://ift.tt/2DWf66L
Congenital cytomegalovirus infection inducing non-congenital sensorineural hearing loss during childhood; a systematic review
Publication date: Available online 4 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Maria Riga, George Korres, Pantelis Chouridis, Stephanos Naxakis, Vasilios Danielides
Abstract
Background
Congenital cytomegalovirus (CMV) infection is one of the most important risk factors for delayed onset and progressive hearing loss in children. However, the relevant literature is limited, heterogeneous and currently insufficient to provide guidance toward the effective monitoring of hearing acuity in these children.
Objectives
The aim of this study was to provide a systematic review focused on types of hearing loss that may escape diagnosis through universal neonatal hearing screening and/or present significant changes during childhood, such as progressive, fluctuating and late-onset hearing loss.
Data sources
A review of the present literature was conducted via the PubMed database of the US National Library of Medicine (www.pubmed.org) and Scopus database (www.scopus.com) with the search terms "late-onset hearing loss cytomegalovirus", "progressive hearing loss cytomegalovirus" and "fluctuating hearing loss cytomegalovirus".
Study eligibility criteria
Prospective or retrospective clinical studies were included if they presented a detailed audiological assessment, for a follow-up period of >2years.
Methods
The prevalence and time of diagnosis of progressive, fluctuating and late-onset hearing loss were considered as primary outcomes. Results were recorded separately for symptomatic and asymptomatic children, when possible.
Results
This analysis refers to a population of 181 children with CMV-induced hearing loss, who were diagnosed among 1089 with congenital CMV infection. The prevalence of CMV-induced hearing loss was significantly higher among symptomatic children (p<0.0001), who were also significantly more likely to develop bilateral hearing loss (p=0.001). There was not sufficient information on the prevalence, laterality, degree and time of diagnosis of progressive, fluctuating and late-onset hearing loss that could constitute the basis toward the report of specific follow-up guidelines.
Conclusions
Further studies are needed in order to understand and quantify the potential effects of congenital CMV infection in the inner ear and hearing acuity. The results presented in the relative studies should be very carefully evaluated and compared to each other, since they correspond to substantially different cohorts, study designs, and result elaboration. Infants with congenital CMV infection should be closely monitored, regarding their hearing acuity at least during their preschool years, although substantial changes in hearing thresholds have been reported as late as the 16th year of age. Parental counseling is of outmost importance in order to minimize the numbers of children lost to follow-up.
https://ift.tt/2y15pyx
Neurologically Acquired Laryngomalacia in a Pediatric Patient with Moyamoya: A Case Report and Literature Review
Publication date: Available online 4 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Hayley Born, Andre Wineland, Michael J. Rutter
Abstract
Acquired laryngomalacia in the pediatric population is rare, especially from a neurogenic cause. This case report describes a pediatric patient who developed laryngomalacia following a neurologic insult. A proposed physiologic pathway is reviewed. A thorough literature review was performed to identify cases of acquired laryngomalacia ascribed to a neurologic cause and are compared to this case.
https://ift.tt/2P7NcpO
Urine concentrations changes of cysteinyl leukotrienes in non-obese children with obstructive sleep apnea undergoing adenotonsillectomy
Publication date: Available online 4 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): George Κ. Mousailidis, Vasileios A. Lachanas, Afroditi Vasdeki, Emmanuel I. Alexopoulos, Athanasios G. Kaditis, Petinaki Efthymia, Nick Balatsos, John G. Bizakis, Charalampos E. Skoulakis
Abstract
Objective
The main objective of the study was to compare preoperative to postoperative levels of urine-Cysteinyl leukotrienes (uCysLT) in children undergoing adenotonsillectomy (AT) for obstructive sleep apnea (OSA) in order to investigate whether exaggerated leukotriene activity is the cause or consequence of OSA.
Methods and materials
A prospective study was conducted on non-obese children (4-10 years old) referred for overnight PSG. Children with moderate/severe OSA treated with AT were included. A second PSG study performed 2 months postoperatively to confirm OSA resolution, and those with residual OSA were excluded. Morning urine specimens after both PSG studies were obtained and pre-operative uCysLT levels were compared to postoperative levels.
Results
27 children fulfilled the criteria and underwent a post-operative PSG study with three exclusions for residual OSA (postop-AHI>2), so the study group consisted of 24 children (mean age: 5.7±2.1 years). Mean preoperative and postoperative AHI was 10.96±5.93 and 1.44±0.56 respectively. Mean preop-uCysLT were 21.14±4.65, while after AT they significantly reduced to 12.62±2.67 (P<0.01).
Conclusion
uCysLT levels are significantly reduced after AT in non-obese children with moderate/severe OSA, suggesting that exaggerated leukotriene activity is mainly a consequence of OSA.
https://ift.tt/2y15d2h
Trends in Sociodemographic Disparities of Pediatric Cochlear Implantation over a 15-Year Period
Publication date: Available online 4 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Alex J.F. Tampio, Ronald J. Schroeder, Dongliang Wang, John Boyle, Brian D. Nicholas
Abstract
Objective
Sociodemographic disparities of cochlear implantation in children have been reported. This study sought to determine if disparities in children receiving cochlear implants have narrowed, widened or remained constant.
Methods
Children 18 years or younger who underwent cochlear implantation from 1997-2012 were selected using the Kids' Inpatient Database. Demographic data included primary insurance payer, income quartile and race. The Cochran-Armitage test was used to determine if trends were significant. Prevalence rates of cochlear implantation by race were generated. A Poisson regression model was used to evaluate the rates of cochlear implantation within each racial group.
Results
The proportion of children receiving cochlear implants with private insurance decreased from 79.3% to 42.6% (p < .0001), whereas children with Medicaid increased from 17.4% to 35.2% (p < .0001). Proportion of implanted children from the lowest two income quartiles increased from 15.5% to 24.4% (p < .0001) and 10.3% to 21.8% (p < .0035), respectively. Rates of implantation among children from income quartile four decreased from 50.9% to 35.3% (p < .0001). White children were implanted twice as often as Black or Hispanic children (p = 0.007 and p = 0.0012 respectively). Asian children were implanted more than twice as often as Black or Hispanic Children (p = .0154 and p = .0098 respectively).
Conclusions
Income and insurance disparities have narrowed within the inpatient pediatric cochlear implantation cohort. Racial disparities still exist. White and Asian children are implanted at higher rates than Black or Hispanic children.
https://ift.tt/2P986ok
Corrigendum to 'Epidemiological characteristics of pediatric epistaxis presenting to the emergency department' International Journal of Pediatric Otorhinolaryngology (2017) 121-124
Publication date: Available online 3 October 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Sophie Shay, Nina L. Shapiro, Neil Bhattacharyya
https://ift.tt/2y151jz
Identification of Baseline Factors Associated With Development of Depression in Head and Neck Cancer
https://ift.tt/2RpPRfQ
The Role of Otolaryngologists in Eradicating Human Papillomavirus
https://ift.tt/2IERceT
Cognitive Behavioral Therapy for Tinnitus Unbound
https://ift.tt/2Rqnxdi
The Role of Otolaryngologists in Eradicating Human Papillomavirus—Reply
https://ift.tt/2ICE5uP
Effectiveness of Internet Cognitive Behavioral Therapy vs Face-to-Face Care for Tinnitus Treatment
https://ift.tt/2Rqn6Qc
The 2018 American Head and Neck Society Presidential Address—Reflections
https://ift.tt/2IH3d3G
Interaction of Group B Streptococcus sialylated capsular polysaccharides with host Siglec-like molecules dampens the inflammatory response in tilapia
Publication date: November 2018
Source: Molecular Immunology, Volume 103
Author(s): Junjian Dong, Yuanzheng Wei, Chengfei Sun, Yuanyuan Tian, Jie Hu, Hongya Shi, Dengfeng Zhang, Maixin Lu, Xing Ye
Abstract
Group B Streptococcus (GBS, S. agalactiae) infection in tilapia (Oreochromis niloticus) causes widespread death of this species and is a significant issue for the aquaculture industry. The major virulence factor for GBS is its sialylated capsular polysaccharides (CPs). These CPs interact with sialic acid-binding immunoglobulin-like lectins (Siglecs) on the host immune cells to regulate the downstream inflammatory response and evade detection. Previously, we cloned multiple Siglec-like molecules from an O. niloticus cDNA library, all of which were shown to interact with the sialylated CPs of GBS. In the present study, we investigated the effects of GBS infection on the expression of pro- and anti-inflammatory cytokines in O. niloticus as well as OnSiglec-like-transfected macrophage cells. Eukaryotic expression vectors containing full-length OnSiglec-1-like, -4b-like, -14-like were constructed and used to transfect RAW264 macrophages in vitro as well as live tilapia in vivo prior to GBS infection. The expression of the anti-inflammatory cytokine interleukin (IL)-10 and the pro-inflammatory cytokines tumor necrosis factor (TNF)-α, IL-6, and interferon (INF)-β were then analyzed by qPCR. Our results indicate that as infection progressed, IL-10 expression was significantly upregulated, while that of TNF-α and IL-6 were significantly downregulated in the OnSiglec-like-transfected cells. INF-β expression was also downregulated in cells transfected with OnSiglec-1-like and -4b-like, but was not significantly effected in OnSiglec-14-like-transfected cells. Notably, the magnitude of these cytokine expression changes was greatly decreased when a ΔneuA GBS mutant was used to infect the OnSiglec-1-like-transfected cells. In GBS-infected tilapia, IL-10 expression was significantly upregulated in all tissues, whereas INF-β expression in the spleen, kidney, and gills was significantly downregulated at 12 hpi. While the expression of TNF-α was slightly upregulated, this change was not significant. In GBS ΔneuA mutant-infected O. niloticus, IL-10 expression in all of the tissues was significantly lower than that observed for the wild-type GBS group, while TNF-α expression was higher in the mutant infected group. There was no significant difference in INF-β expression between the two groups. Taken together, sialylated CPs on GBS appear to interact with host OnSiglec-like molecules to transmit negative regulatory signals via enhanced anti-inflammatory cytokine IL-10 production and reduced pro-inflammatory cytokine production, ultimately leading to dampening of the host immune response. The results of this study further elucidate the molecular mechanism underlying GBS infection in tilapia and also provide candidate drug target molecules.
https://ift.tt/2xXY9n8
Afatinib and Pembrolizumab for Head and Neck Squamous Cell Carcinoma (ALPHA Study)
Interventions: Drug: Afatinib Oral Tablet; Drug: Pembrolizumab Injection
Sponsor: National Taiwan University Hospital
Not yet recruiting
https://ift.tt/2xV1jIk
Aged complement factor H knockout mice kept in a clean barriered environment have reduced retinal pathology
Kam, JH; Morgan, JE; Jeffery, G; (2016) Aged complement factor H knockout mice kept in a clean barriered environment have reduced retinal pathology. Experimental Eye Research , 149 pp. 116-125. 10.1016/j.exer.2016.07.002 . Green open access
https://ift.tt/2OBfJqJ
Informal caregivers of people with an intellectual disability in England: health, quality of life and impact of caring
Totsika, V; Hastings, RP; Vagenas, D; (2016) Informal caregivers of people with an intellectual disability in England: health, quality of life and impact of caring. Health & Social Care in the Community , 25 (3) pp. 951-961. 10.1111/hsc.12393 . Green open access
https://ift.tt/2DWWEer
Parents' and healthcare professionals' experiences of care after stillbirth in low- and middle-income countries: a systematic review and meta-summary
Shakespeare, C; Merriel, A; Bakhbakhi, D; Baneszova, R; Barnard, K; Lynch, M; Storey, C; ... Siassakos, D; + view all Shakespeare, C; Merriel, A; Bakhbakhi, D; Baneszova, R; Barnard, K; Lynch, M; Storey, C; Blencowe, H; Boyle, F; Flenady, V; Gold, K; Horey, D; Mills, T; Siassakos, D; - view fewer (2018) Parents' and healthcare professionals' experiences of care after stillbirth in low- and middle-income countries: a systematic review and meta-summary. BJOG - International Journal of Obstetrics and Gynaecology 10.1111/1471-0528.15430 . (In press).
https://ift.tt/2OGmiZe
The Economics of Higher Education
Wyness, G (Ed). (2018) The Economics of Higher Education. [Book]. Routledge: Abingdon, UK.
https://ift.tt/2DVgTJi
9.4T MR microscopy of the substantia nigra with pathological validation in controls and disease
Massey, LA; Miranda, MA; Al-Helli, O; Parkes, HG; Thornton, JS; So, P-W; White, MJ; ... Yousry, TA; + view all Massey, LA; Miranda, MA; Al-Helli, O; Parkes, HG; Thornton, JS; So, P-W; White, MJ; Mancini, L; Strand, C; Holton, J; Lees, AJ; Revesz, T; Yousry, TA; - view fewer (2016) 9.4T MR microscopy of the substantia nigra with pathological validation in controls and disease. NeuroImage: Clinical , 13 pp. 154-163. 10.1016/j.nicl.2016.11.015 . Green open access
https://ift.tt/2OzAVx9
Enhancing Behavior Change Technique Coding Methods: Identifying Behavioral Targets and Delivery Styles in Smoking Cessation Trials
Black, N; Williams, AJ; Javornik, N; Scott, C; Johnston, M; Eisma, MC; Michie, S; ... de Bruin, M; + view all Black, N; Williams, AJ; Javornik, N; Scott, C; Johnston, M; Eisma, MC; Michie, S; Hartmann-Boyce, J; West, R; Viechtbauer, W; de Bruin, M; - view fewer (2018) Enhancing Behavior Change Technique Coding Methods: Identifying Behavioral Targets and Delivery Styles in Smoking Cessation Trials. Annals of Behavioral Medicine , Article kay068. 10.1093/abm/kay068 . (In press).
https://ift.tt/2DVgKFK
A direct method for the N-tetraalkylation of azamacrocycles
Counsell, AJ; Jones, AT; Todd, MH; Rutledge, PJ; (2016) A direct method for the N-tetraalkylation of azamacrocycles. Beilstein Journal of Organic Chemistry , 12 pp. 2457-2461. 10.3762/bjoc.12.239 . Green open access
https://ift.tt/2OuVUkX
LUBAC prevents lethal dermatitis by inhibiting cell death induced by TNF, TRAIL and CD95L
Taraborrelli, L; Peltzer, N; Montinaro, A; Kupka, S; Rieser, E; Hartwig, T; Sarr, A; ... Walczak, H; + view all Taraborrelli, L; Peltzer, N; Montinaro, A; Kupka, S; Rieser, E; Hartwig, T; Sarr, A; Darding, M; Draber, P; Haas, TL; Akarca, A; Marafioti, T; Pasparakis, M; Bertin, J; Gough, PJ; Bouillet, P; Strasser, A; Leverkus, M; Silke, J; Walczak, H; - view fewer (2018) LUBAC prevents lethal dermatitis by inhibiting cell death induced by TNF, TRAIL and CD95L. Nature Communications , 9 (1) , Article 3910. 10.1038/s41467-018-06155-8 . Green open access
https://ift.tt/2DUZTTO
Data for "Low-noise 1.3 μm InAs/GaAs quantum dot laser monolithically grown on silicon"
Liao, M; Chen, S; Liu, Z; Wang, Y; Ponnampalam, L; Wu, J; Tang, M; ... Liu, H; + view all Liao, M; Chen, S; Liu, Z; Wang, Y; Ponnampalam, L; Wu, J; Tang, M; Shutts, S; Liu, Z; Smowton, PM; Yu, S; Seeds, A; Liu, H; - view fewer (2018) Data for "Low-noise 1.3 μm InAs/GaAs quantum dot laser monolithically grown on silicon". [Dataset]. UCL Department of Electronic and Electrical Engineering: London, UK. Green open access
https://ift.tt/2OAxp5I
Stafne bone cavity containing ectopic parotid gland
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Mesut Kaya, Kadriye Serife Ugur, Elif Dagli, Hanifi Kurtaran, Mehmet Gunduz
https://ift.tt/2O4G3d7
Effects of cavity reconstruction on morbidity and quality of life after canal wall down tympanomastoidectomy
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Sinan Uluyol, Omer Ugur, Ilker Burak Arslan, Ozlem Yagiz, Murat Gumussoy, Ibrahim Cukurova
Abstract
Introduction
Canal wall down tympanomastoidectomy is commonly used to treat advanced chronic otitis media or cholesteatoma. The advantages of canal wall down mastoidectomy are excellent exposure for disease eradication and postoperative control of residual disease; its disadvantages include the accumulation of debris requiring life-long otological maintenance and cleaning, continuous ear drainage, fungal cavity infections, and the occurrence of dizziness and vertigo by changing temperature or pressure.
Objective
To evaluate whether cavity-induced problems can be eliminated and patient comfort can be increased with mastoid cavity reconstruction.
Methods
In total, 11 patients who underwent mastoid cavity reconstruction between March 2013 and June 2013 comprised the study group, and 11 patients who had dry, epithelialized CWD cavities were recruited as the control group. The study examined three parameters: epithelial migration, air caloric testing, and the Glasgow Benefit Inventory. Epithelial migration, air caloric testing, and the Glasgow Benefit Inventory were evaluated in the study and control groups.
Results
The epithelial migration rate was significantly faster in study group (1.63 ± 0.5 mm/week) than control group (0.94 ± 0.37 mm/week) (p = 0.003, p < 0.05). The mean slow component velocity of nystagmus of the study group (13.33 ± 5.36°/s) was significantly lower when compared to control group (32.11 ± 9.12°/s) (p = 0.018). The overall the Glasgow Benefit Inventory score was −7.21, and the general subscale, physical and social health scores were −9.71, −21.09, and +20.35, respectively in the control group. These were +33.93, +35.59, +33.31, and +29.61, respectively in the study group. All but the social health score improved significantly (0.007, 0.008, 0.018, and 0.181, respectively).
Conclusions
Cavity reconstruction improves epithelial migration, normalizes caloric responses and increases the quality of life. Thus, cavity rehabilitation eliminates open-cavity-induced problems by restoring the functional anatomy of the ear.
Resumo
Introdução
A timpanomastoidectomia com a técnica Canal Wall Down, ou técnica aberta, é comumente utilizada para tratar otite média crônica avançada ou colesteatoma. As vantagens da mastoidectomia pela técnica aberta são uma excelente exposição para a erradicação da doença e controle pós-operatório da doença residual; suas desvantagens incluem o acúmulo de detritos que requerem manutenção e limpeza otológica ao longo da vida, drenagem contínua da orelha, infecções fúngicas na cavidade e a ocorrência de tonturas e vertigem com alterações de temperatura ou pressão.
Objetivo
Avaliar se os problemas induzidos pela cavidade podem ser eliminados e o conforto do paciente aumentado com a reconstrução da cavidade mastoide.
Método
No total, 11 pacientes submetidos à reconstrução da cavidade mastoide entre março de 2013 e junho de 2013 constituíram o grupo de estudo, e 11 pacientes com cavidades secas e epitelizadas, operadas pela técnica aberta, foram recrutados como grupo controle. O estudo analisou três parâmetros: migração epitelial, prova calórica com estimulação a ar e o questionário Glasgow Benefit Inventory. A migração epitelial, a prova calórica e o Glasgow Benefit Inventory foram avaliados nos grupos de estudo e controle.
Resultados
A taxa de migração epitelial foi significativamente mais rápida no grupo de estudo (1,63 ± 0,5 mm/semana) do que no grupo controle (0,94 ± 0,37 mm/semana) (p = 0,003, p < 0,05). A velocidade média do componente lento do nistagmo no grupo de estudo (13,33 ± 5,36°/s) foi significativamente menor se comparada ao grupo controle (32,11 ± 9,12°/s) (p = 0,018). O escore global do Glasgow Benefit Inventory foi de -7,21 e os escores da subescala geral, saúde física e social foram -9,71, -21,09 e +20,35, respectivamente, no grupo controle. Esses escores foram +33.93, +35.59, +33.31 e +29.61, respectivamente, no grupo de estudo. Todos, exceto o escore de saúde social, melhoraram significativamente (0,007, 0,008, 0,018 e 0,181, respectivamente).
Conclusões
A reconstrução da cavidade melhora a migração epitelial, normaliza as respostas da prova calórica e aumenta a qualidade de vida. Assim, a reabilitação da cavidade elimina os problemas induzidos por cavidades abertas ao restaurar a anatomia funcional da orelha.
https://ift.tt/2ydtx0g
Association of Ugrp2 gene polymorphisms with adenoid hypertrophy in the pediatric population
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Mahmut Huntürk Atilla, Sibel Özdaş, Talih Özdaş, Sibel Baştimur, Sami Engin Muz, Işılay Öz, Kenan Kurt, Afife İzbirak, Mehmet Ali Babademez, Nilgün Vatandaş
Abstract
Introduction
Adenoid hypertrophy is a condition that presents itself as the chronic enlargement of adenoid tissues; it is frequently observed in the pediatric population. The Ugrp2 gene, a member of the secretoglobin superfamily, encodes a low-molecular weight protein that functions in the differentiation of upper airway epithelial cells. However, little is known about the association of Ugrp2 genetic variations with adenoid hypertrophy.
Objective
The aim of this study is to investigate the association of single nucleotide polymorphisms in the Ugrp2 gene with adenoid hypertrophy and its related phenotypes.
Methods
A total of 219 children, comprising 114 patients suffering from adenoid hypertrophy and 105 healthy patients without adenoid hypertrophy, were enrolled in this study. Genotypes of the Ugrp2 gene were determined by DNA sequencing.
Results
We identified four single nucleotide polymorphisms (IVS1-189G>A, IVS1-89T>G, c.201delC, and IVS2-15G>A) in the Ugrp2 gene. Our genotype analysis showed that the Ugrp2 (IVS1-89T>G) TG and (c.201delC) CdelC genotypes and their minor alleles were associated with a considerable increase in the risk of adenoid hypertrophy compared with the controls (p = 0.012, p = 0.009, p = 0.013, and p = 0.037, respectively). Furthermore, Ugrp2 (GTdelCG, GTdelCA) haplotypes were significantly associated with adenoid hypertrophy (four single nucleotide polymorphisms ordered from 5′ to 3′; p = 0.0001). Polymorfism–Polymorfism interaction analysis indicated a strong interaction between combined genotypes of the Ugrp2 gene contributing to adenoid hypertrophy, as well as an increased chance of its diagnosis (p < 0.0001). In addition, diplotypes carrying the mutant Ugrp2 (c.201delC) allele were strongly associated with an increased risk of adenoid hypertrophy with asthma and with allergies (p = 0.003 and p = 0.0007, respectively).
Conclusion
Some single nucleotide polymorphisms and their combinations in the Ugrp2 gene are associated with an increased risk of developing adenoid hypertrophy. Therefore, we tried to underline the importance of genetic factors associated with adenoid hypertrophy and its related clinical phenotypes.
Resumo
Introdução
A adenoide ou hipertrofia de tonsila faríngea é uma condição que se apresenta como o aumento crônico de tecidos linfóides na rinofaringe e é frequentemente observada na população pediátrica. O gene Ugrp2, um membro da superfamília da secretoglobina, codifica uma proteína de baixo peso molecular que funciona na diferenciação das células epiteliais das vias aéreas superiores. No entanto, pouco se sabe sobre a associação de variações genéticas do Ugrp2 com hipertrofia de tonsila faríngea.
Objetivo
Investigar a associação de polimorfismos de nucleotídeos únicos no gene Ugrp2 com hipertrofia de tonsila faríngea e seus fenótipos relacionados.
Método
Foram incluídos no estudo 219 crianças, 114 pacientes com hipertrofia de tonsila faríngea e 105 saudáveis. Os genótipos do gene Ugrp2 foram determinados por sequenciamento de DNA.
Resultados
Identificamos quatro polimorfismos de nucleotídeo único (IVS1-189G>A, IVS1-89T>G, c.201delC, e IVS2-15G>A) no gene Ugrp2. Nossa análise genotípica mostrou que os genótipos Ugrp2 (IVS1-89T>G) TG e (c.201delC) CdelC e seus alelos menores foram associados a um aumento considerável no risco de HA em comparação com os controles (p = 0,012, p = 0,009, p = 0,013 e p = 0,037, respectivamente). Além disso, os haplótipos Ugrp2 (GTdelCG, GTdelCA) foram significativamente associados com hipertrofia de tonsila faríngea (quatro polimorfismos de nucleot' ordenados de 5' a 3'; p = 0,0001). A análise de interação polimorfismo-polimorfismo indicou uma forte interação entre genótipos combinados do gene Ugrp2 que contribuiu para hipertrofia de tonsila faríngea, bem como uma chance maior de seu diagnóstico (p < 0,0001). Além disso, os diplótipos que transportam o alelo mutante Ugrp2 (c.201delC) foram fortemente associados a um risco aumentado de hipertrofia de tonsila faríngea com asma e com alergias (p = 0,003 e p = 0,0007, respectivamente).
Conclusão
Alguns polimorfismos de nucleotídeo único e suas combinações no gene Ugrp2 estão associados a um risco aumentado de desenvolver hipertrofia de tonsila faríngea. Portanto, tentamos enfatizar a importância dos fatores genéticos e fenótipos clínicos associados à essa hipertrofia.
https://ift.tt/2O4G14Z
Disease-specific quality of life after septoplasty and bilateral inferior turbinate outfracture in patients with nasal obstruction
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Lucas Resende, Carolina do Carmo, Leão Mocellin, Rogério Pasinato, Marcos Mocellin
Abstract
Introduction
Septal deviations might cause nasal obstruction and negative impact on the quality of life of individuals. The efficacy of septoplasty for treatment of septal deviation and the predictors of satisfactory surgical outcomes remain controversial. Technical variability, heterogeneity of research samples and absence of a solid tool for clinical evaluation are the main hindrances to the establishment of reliable statistical data regarding the procedure.
Objective
To evaluate the clinical improvements in the disease-specific quality-of-life between patients submitted to septoplasty with bilateral outfracture of the inferior turbinate under sedation and local anesthesia in a tertiary hospital and to assess possible clinical–epidemiological variables associated with functional outcome.
Methods
Fifty-two patients consecutively submitted to septoplasty with bilateral outfracture of the inferior turbinate for treatment of nasal obstruction filled in forms regarding clinical and epidemiological information during enrollment and had their symptom objectively quantified using the Nose Obstruction Symptom Evaluation (NOSE) scale preoperatively and one and three months after the procedure. Statistical analysis aimed to determine overall and stratified surgical outcomes and to investigate correlations between the clinical–epidemiological variables with the scores obtained.
Results
Statistically significant improvement in the preoperative NOSE questionnaire compared to the scores obtained three months after surgery was demonstrated (p < 0.001, T-Wilcoxon), with strong correlation between the preoperative score and the postoperative improvement during this period (r = −0.614, p < 0.001, Spearman). After one month, patients reached in average 87.15% of the result obtained at the study termination. Smokers and patients with rhinitis and/or pulmonary comorbidity showed increased average preoperative NOSE scores, although without statistical significance (p > 0.05). Gender, age, history of rhinitis and presence of pulmonary comorbidity did not influence significantly surgical outcomes (p > 0.05). Smokers presented greater reduction in NOSE scores during the study (p = 0.043, U-Mann–Whitney).
Conclusion
Septoplasty with bilateral outfracture of the inferior turbinate has proven to significantly improve disease-specific quality-of-life and this favorable outcome seems to occur precociously.
Resumo
Introdução
Os desvios septais podem causar obstrução nasal e impacto negativo na qualidade de vida dos indivíduos. A eficácia da septoplastia para o tratamento do desvio septal e os preditores de resultados cirúrgicos satisfatórios continuam controversos. A variabilidade técnica, a heterogeneidade das amostras de estudo e a ausência de uma ferramenta sólida para avaliação clínica são os principais obstáculos ao estabelecimento de dados estatísticos confiáveis sobre o procedimento.
Objetivo
Avaliar a melhora clínica na qualidade de vida específica da doença entre pacientes submetidos a septoplastia e fratura bilateral da concha inferior sob sedação e anestesia local em um hospital terciário e possíveis variáveis clínico-epidemiológicas associadas ao desfecho funcional.
Método
Cinquenta e dois pacientes consecutivamente submetidos a septoplastia e fratura bilateral da concha inferior para o tratamento da obstrução nasal preencheram formulários com informações clínicas e epidemiológicas durante a inclusão no estudo e tiveram seus sintomas quantificados objetivamente utilizando a escala de Avaliação de Sintomas de Obstrução Nasal (Nose Obstruction Symptom Evaluation - NOSE) no pré-operatório e um e três meses após o procedimento. A análise estatística objetivou determinar resultados cirúrgicos globais e estratificados e investigar correlações entre as variáveis clínico-epidemiológicas e os escores obtidos.
Resultados
Foi demonstrada uma melhora estatisticamente significativa nos escores obtidos no questionário NOSE três meses após a cirurgia (p < 0,001, T-Wilcoxon), quando comparado com os escores obtidos no pré-operatório, com uma forte correlação entre o escore pré-operatório e a melhora pós-operatória durante esse período (r = -0,614, p < 0,001, Spearman). Após um mês, os pacientes atingiram em média 87,15% do resultado obtido ao término do estudo. Fumantes e pacientes com rinite e/ou comorbidade pulmonar apresentaram valores médios pré-operatórios do escore NOSE aumentados, embora sem significância estatística (p > 0,05). Sexo, idade, história de rinite e presença de comorbidade pulmonar não influenciaram significativamente os resultados cirúrgicos (p > 0,05). Os fumantes apresentaram maior redução nos escores de NOSE (p = 0,043, U-Mann-Whitney).
Conclusão
A septoplastia e fratura bilateral da concha inferior demonstraram melhorar significativamente a qualidade de vida específica da doença e este resultado favorável parece ocorrer de forma precoce.
https://ift.tt/2ycOloQ
Psychoacoustic classification of persistent tinnitus
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Flavia Alencar de Barros Suzuki, Fabio Akira Suzuki, Ektor Tsuneo Onishi, Norma Oliveira Penido
Abstract
Introduction
Tinnitus is a difficult to treat symptom, with different responses in patients. It is classified in different ways, according to its origin and associated diseases.
Objective
to propose a single and measurable classification of persistent tinnitus, through its perception as sounds of nature or of daily life and its comparison with pure tone or noise, of high or low pitch, presented to the patient by audiometer sound.
Methods
A total of 110 adult patients, of both genders, treated at the Tinnitus Outpatient Clinic, were enrolled according to the inclusion and exclusion criteria. Otorhinolaryngologic and Audiological, Pitch Matching and Loudness, Visual Analog Scale, Tinnitus Handicap Inventory and Minimum Masking Level assessments were performed.
Results
In these 110 patients, 181 tinnitus complaints were identified accordingly to type and ear, with 93 (51%) Pure Tone, and 88 (49%) Noise type; 19 at low and 162 at high frequency; with a mean in the Pure Tone of 5.47 in the Visual Analog Scale and 12.31 decibel in the Loudness and a mean in the Noise of 6.66 and 10.51 decibel. For Tinnitus Handicap Inventory and Minimum Masking Level, the 110 patients were separated into three groups with tinnitus, Pure Tone, Noise and multiple. Tinnitus Handicap Inventory higher in the group with multiple tinnitus, of 61.38. Masking noises such as White Noise and Narrow Band were used for the Minimum Masking Level at the frequencies of 500 and 6000 Hz. There was a similarity between the Pure Tone and Multiple groups. In the Noise group, different responses were found when Narrow Band was used at low frequency.
Conclusion
Classifying persistent tinnitus as pure tone or noise, present in high or low frequency and establishing its different characteristics allow us to know its peculiarities and the effects of this symptom in patients' lives.
Resumo
Introdução
O zumbido é um sintoma de difícil tratamento, com respostas diferentes nos pacientes. É classificado de formas diversas, de acordo com a origem ou doenças associadas.
Objetivo
Propor uma classificação única e mensurável do zumbido persistente, por meio da sua percepção como sons da natureza ou da vida cotidiana e da sua comparação com o tom puro ou o ruído, de pitch alto ou baixo, apresentados ao paciente pelos sons do audiômetro.
Método
Participaram 110 pacientes adultos, de ambos os sexos, atendidos no Ambulatório de Zumbido, tendo sido observados os critérios de inclusão e exclusão. Realizada avaliação otorrinolaringológica, audiológica, Pitch Matching e Loudness, Visual Analog Scale, Tinnitus Handicap Inventory e Minimum Masking Level.
Resultados
Nesses 110 pacientes foram identificadas 181 queixas de zumbido separadas por tipo e orelha, sendo 93 (51%) tipo tom puro e 88 (49%) tipo ruído; 19 de baixa frequência e 162 de alta frequência; com média do Visual Analog Scale no tom puro de 5,47 e ruído de 6,66; média do Loudness do tom puro de 12,31 dBNS e ruído de 10,51 dBNS. Para o Tinnitus Handicap Inventory e o Minimum Masking Level os 110 pacientes foram separados em três grupos com zumbido, tom puro, ruído e múltiplo, com a média do Tinnitus Handicap Inventory maior no grupo com zumbido múltiplo com 61,38. Para o Minimum Masking Level foram usados os ruídos mascaradores tipo White Noise e Narrow Band nas frequências de 500 Hz e 6000 Hz. Houve semelhança entre os grupos com tom puro e múltiplo. No grupo de ruído foram encontradas respostas diferentes quando usado o Narrow Band em frequência baixa.
Conclusão
Classificar o zumbido persistente em tom puro ou ruído, presentes em frequência alta ou baixa e estabelecer suas diferentes características nos permitem conhecer suas particularidades e a repercussão desse sintoma na vida dos pacientes.
https://ift.tt/2O6Kwfo
Audiological and electrophysiological alterations in HIV-infected individuals subjected or not to antiretroviral therapy
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Carla Gentile Matas, Alessandra Giannella Samelli, Fernanda Cristina Leite Magliaro, Aluisio Segurado
Abstract
Introduction
The Human Immunodeficiency Virus (HIV) and infections related to it can affect multiple sites in the hearing system. The use of High Activity Anti-Retroviral Therapy (HAART) can cause side effects such as ototoxicity. Thus, no consistent patterns of hearing impairment in adults with Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome have been established, and the problems that affect the hearing system of this population warrant further research.
Objectives
This study aimed to compare the audiological and electrophysiological data of Human Immunodeficiency Virus-positive patients with and without Acquired Immune Deficiency Syndrome, who were receiving High Activity Anti-Retroviral Therapy, to healthy individuals.
Methods
It was a cross-sectional study conducted with 71 subjects (30–48 years old), divided into groups: Research Group I: 16 Human Immunodeficiency Virus-positive individuals without Acquired Immunodeficiency Syndrome (not receiving antiretroviral treatment); Research Group II: 25 Human Immunodeficiency Virus-positive individuals with Acquired Immunodeficiency Syndrome (receiving antiretroviral treatment); Control Group: 30 healthy subjects. All individuals were tested by pure-tone air conduction thresholds at 0.25–8 kHz, extended high frequencies at 9–20 kHz, electrophysiological tests (Auditory Brainstem Response, Middle Latency Responses, Cognitive Potential).
Results
Research Group I and Research Group II had higher hearing thresholds in both conventional and high frequency audiometry when compared to the control group, prolonged latency of waves I, III, V and interpeak I–V in Auditory Brainstem Response and prolonged latency of P300 Cognitive Potential. Regarding Middle Latency Responses, there was a decrease in the amplitude of the Pa wave of Research Group II compared to the Research Group I.
Conclusions
Both groups with Human Immunodeficiency Virus had higher hearing thresholds when compared to healthy individuals (group exposed to antiretroviral treatment showed the worst hearing threshold) and seemed to have lower neuroelectric transmission speed along the auditory pathway in the brainstem, subcortical and cortical regions.
Resumo
Introdução
O HIV e as infecções relacionadas a ele podem afetar vários locais do sistema auditivo. O uso de terapia antirretroviral altamente ativa pode causar efeitos colaterais, como ototoxicidade. Assim, não foram estabelecidos padrões consistentes de deficiência auditiva em adultos com HIV/Aids e os problemas que afetam o sistema auditivo dessa população justificam pesquisas futuras.
Objetivos
Este estudo teve como objetivo comparar os dados audiológicos e eletrofisiológicos de pacientes HIV positivos com e sem Aids que recebiam terapia antirretroviral altamente ativa com os de indivíduos saudáveis.
Método
Estudo transversal com 71 indivíduos (30-48 anos), dividido em grupos: Grupo de Pesquisa I: 16 indivíduos HIV-positivos sem Aids (não recebendo tratamento antirretroviral); Grupo de Pesquisa II: 25 indivíduos HIV-positivos com Aids (recebiam tratamento antirretroviral); Grupo Controle: 30 indivíduos saudáveis. Todos os indivíduos foram testados para limiares de condução aérea de tons puros a 0,25-8 kHz, altas frequências de 9-20 kHz, testes eletrofisiológicos (potencial evocado auditivo de tronco encefálico, potencial evocado auditivo de média latência, potencial cognitivo).
Resultados
Os grupos de pesquisa I e II apresentaram limiares auditivos mais elevados em audiometria convencional e nas frequências altas quando comparados com o grupo controle, latência prolongada das ondas I, III, V e interpico I-V em resposta auditiva de tronco encefálico e latência prolongada de P300. Em relação às respostas de latência média, houve uma diminuição na amplitude da onda Pa do Grupo de pesquisa II em comparação com o grupo de pesquisa I.
Conclusões
Ambos os grupos com HIV apresentaram limiares auditivos mais elevados quando comparados aos indivíduos saudáveis (o grupo exposto ao tratamento antirretroviral apresentou o pior limiar auditivo) e parecem ter menor velocidade de transmissão neuroelétrica ao longo da via auditiva nas regiões do tronco encefálico, subcortical e cortical.
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Prognostic significance of soft tissue deposits in laryngeal carcinoma
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Omer Afsin Ozmen, Melih Alpay, Ozlem Saraydaroglu, Uygar Levent Demir, Fikret Kasapoglu, Hamdi Hakan Coskun, Oguz Ibrahim Basut
Abstract
Introduction
Soft tissue deposits is tumorous islands apart from lymph nodes and occasionally diagnosed in neck dissection specimens. Their importance has begun to be recognized, however, their value has not been investigated in laryngeal cancer as a single tumor site.
Objective
To investigate the prognostic value of soft tissue deposits in patients with laryngeal carcinoma.
Methods
Medical records of 194 patients with laryngeal carcinoma who were treated primarily by surgery and neck dissection were reviewed. Prognostic significance of soft tissue deposits was assessed along with other clinical and pathological findings. Recurrence rates, overall and disease-specific survival rates were examined.
Results
The incidence of soft tissue deposits was found to be 7.2% in laryngeal carcinoma. N stage was more advanced in patients who had soft tissue deposits. Regional recurrence rate was higher and disease specific and overall survivals rates were significantly lower in patients with soft tissue deposits in univariate analysis. However, in multivariate analysis, soft tissue deposits were not found as an independent risk factor.
Conclusion
In laryngeal carcinoma, soft tissue deposits was diagnosed in patients with more advanced neck disease and their significance was lesser than other factors including extranodal extension.
Resumo
Introdução
Depósitos de tecido mole são ilhas tumorais diferente dos linfonodos e ocasionalmente diagnosticados em amostras de esvaziamento cervical. Sua importância começou a ser reconhecida, mas seu valor não foi investigado no câncer de laringe como um único local de tumor.
Objetivo
Investigar o valor prognóstico do depósito de tecido mole em pacientes com carcinoma laríngeo.
Método
Os prontuários de 194 pacientes com carcinoma laríngeo tratados principalmente por cirurgia e esvaziamento cervical foram analisados. O significado prognóstico dos depósitos de tecido mole foi avaliado juntamente com outros achados clínicos e histopatológicos. As taxas de recidiva, as taxas de sobrevida geral e específicas da doença foram avaliadas.
Resultados
Observou-se uma incidência de depósitos de tecido mole de 7,2% no carcinoma laríngeo. O estágio N foi mais avançado em pacientes com depósitos de tecido mole. A taxa de recorrência regional foi maior e as taxas de sobrevida geral e específica da doença foram significativamente menores nesses pacientes na análise univariada. No entanto, na análise multivariada, o depósito de tecido mole não foi observado como um fator de risco independente.
Conclusão
No carcinoma laríngeo, o depósito de tecido mole foi diagnosticado em pacientes com doença cervical mais avançada, mas sua significância foi menor do que outros fatores, incluindo a extensão extranodal.
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Is there a best side for cochlear implants in post-lingual patients?
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Maria Stella Arantes do Amaral, Thiago A. Damico, Alina S. Gonçales, Ana C.M.B. Reis, Myriam de Lima Isaac, Eduardo T. Massuda, Miguel Angelo Hyppolito
Abstract
Introduction
Cochlear Implant is a sensory prosthesis capable of restoring hearing in patients with severe or profound bilateral sensorineural hearing loss.
Objective
To evaluate if there is a better side to be implanted in post-lingual patients.
Methods
Retrospective longitudinal study. Participants were 40 subjects, of both sex, mean age of 47 years, with post-lingual hearing loss, users of unilateral cochlear implant for more than 12 months and less than 24 months, with asymmetric auditor reserve between the ears (difference of 10 dBNA, In at least one of the frequencies with a response, between the ears), divided into two groups. Group A was composed of individuals with cochlear implant in the ear with better auditory reserve and Group B with auditory reserve lower in relation to the contralateral side.
Results
There was no statistical difference for the tonal auditory threshold before and after cochlear implant. A better speech perception in pre-cochlear implant tests was present in B (20%), but the final results are similar in both groups.
Conclusion
The cochlear implant in the ear with the worst auditory residue favors a bimodal hearing, which would allow the binaural summation, without compromising the improvement of the audiometric threshold and the speech perception.
Resumo
Introdução
O implante coclear é uma prótese sensorial capaz de restaurar a audição em pacientes com perda auditiva neurossensorial bilateral severa ou profunda.
Objetivo
Avaliar se há um melhor lado para o implante coclear em pacientes pós-linguais.
Método
Estudo longitudinal retrospectivo; incluiu 40 indivíduos, de ambos os sexos, idade média de 47 anos, com perda auditiva pós-lingual, usuários de implante coclear unilateral por mais de 12 meses e menos de 24 meses, com perda auditiva assimétrica entre as orelhas (diferença de 10 dBNA, em pelo menos uma das frequências), divididos em dois grupos. O Grupo A foi composto por indivíduos com implante coclear na orelha com melhor audição residual e Grupo B com menor audição residual em relação ao lado contralateral.
Resultados
Não houve diferença estatística entre o limiar auditivo tonal antes e depois do implante coclear. Uma melhor percepção da fala nos testes pré-implante coclear foi observada no grupo B (20%), mas os resultados finais foram semelhantes em ambos os grupos.
Conclusão
O implante coclear na orelha com pior audição residual favorece uma audição bimodal, o que possibilitaria a somação binaural, sem comprometer a melhora do limiar audiométrico e a percepção da fala.
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Familial misophonia or selective sound sensitivity syndrome : evidence for autosomal dominant inheritance?
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Tanit Ganz Sanchez, Fúlvia Eduarda da Silva
Abstract
Introduction
Misophonia is a recently described, poorly understood and neglected condition. It is characterized by strong negative reactions of hatred, anger or fear when subjects have to face some selective and low level repetitive sounds. The most common ones that trigger such aversive reactions are those elicited by the mouth (chewing gum or food, popping lips) or the nose (breathing, sniffing, and blowing) or by the fingers (typing, kneading paper, clicking pen, drumming on the table). Previous articles have cited that such individuals usually know at least one close relative with similar symptoms, suggesting a possible hereditary component.
Objective
We found and described a family with 15 members having misophonia, detailing their common characteristics and the pattern of sounds that trigger such strong discomfort.
Methods
All 15 members agreed to give us their epidemiological data, and 12 agreed to answer a specific questionnaire which investigated the symptoms, specific trigger sounds, main feelings evoked and attitudes adopted by each participant.
Results
The 15 members belong to three generations of the family. Their age ranged from 9 to 73 years (mean 38.3 years; median 41 years) and 10 were females. Analysis of the 12 questionnaires showed that 10 subjects (83.3%) developed the first symptoms during childhood or adolescence. The mean annoyance score on the Visual Analog Scale from 0 to 10 was 7.3 (median 7.5). Individuals reported hatred/anger, irritability and anxiety in response to sounds, and faced the situation asking to stop the sound, leaving/avoiding the place and even fighting. The self-reported associated symptoms were anxiety (91.3%), tinnitus (50%), obsessive-compulsive disorder (41.6%), depression (33.3%), and hypersensitivity to sounds (25%).
Conclusion
The high incidence of misophonia in this particular familial distribution suggests that it might be more common than expected and raises the possibility of having a hereditary etiology.
Resumo
Introdução
A misofonia é uma condição recentemente descrita, mal compreendida e negligenciada. É caracterizada por fortes reações negativas de ódio, raiva ou medo quando os indivíduos precisam enfrentar alguns sons repetitivos seletivos e de baixa intensidade. Os mais comuns que desencadeiam tais reações aversivas são aqueles provocados pela boca (mascar goma ou mastigar comida, estalar os lábios) ou nariz (respirando, cheirando e soprando) ou pelos dedos (digitando, amassando papel, clicando a caneta, tamborilando na mesa). Artigos anteriores citam que esses indivíduos geralmente conhecem pelo menos um parente próximo com sintomas semelhantes, sugerindo um possível componente hereditário.
Objetivo
Encontramos e descrevemos uma família com 15 membros com misofonia, detalhando suas características comuns e o padrão de sons que desencadeiam um desconforto tão forte.
Método
Todos os 15 membros concordaram em nos fornecer seus dados epidemiológicos e 12 concordaram em responder a um questionário específico que investigou os sintomas, sons de gatilho específicos, principais sentimentos evocados e atitudes adotadas por cada participante.
Resultados
Os 15 membros pertencem a três gerações da família. A idade variou de 9 a 73 anos (média de 38,3 anos, mediana de 41 anos) e 10 eram mulheres. A análise dos 12 questionários mostrou que 10 indivíduos (83,3%) desenvolveram os primeiros sintomas durante a infância ou a adolescência. A média do escore de irritação na Escala Visual Analógica de 0 a 10 foi de 7,3 (mediana 7,5). Os indivíduos relataram sentimentos de ódio/raiva, irritabilidade e ansiedade em resposta a sons, e enfrentaram a situação pedindo para interromper o som, deixando/evitando o lugar e até mesmo discutindo. Os sintomas associados auto-relatados foram ansiedade (91,3%), zumbido (50%), transtorno obsessivo-compulsivo (41,6%), depressão (33,3%) e hipersensibilidade aos sons (25%).
Conclusão
A alta incidência de misofonia nessa distribuição familiar em particular sugere que possa ser mais comum do que o esperado e suscita a possibilidade de haver uma etiologia hereditária.
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Endoscopic observation of different repair patterns in human traumatic tympanic membrane perforations
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Peng Huang, Shujun Zhang, Xinhong Gong, Xuesong Wang, Zi-Han Lou
Abstract
Introduction
In the last decade, there has been an increasing use of biomaterial patches in the regeneration of traumatic tympanic membrane perforations. The major advantages of biomaterial patches are to provisionally restore the physiological function of the middle ear, thereby immediately improving ear symptoms, and act as a scaffold for epithelium migration. However, whether there are additional biological effects on eardrum regeneration is unclear for biological material patching in the clinic.
Objective
This study evaluated the healing response for different repair patterns in human traumatic tympanic membrane perforations by endoscopic observation.
Methods
In total, 114 patients with traumatic tympanic membrane perforations were allocated sequentially to two groups: the spontaneous healing group (n = 57) and Gelfoam patch-treated group (n = 57). The closure rate, closure time, and rate of otorrhea were compared between the groups at 3 months.
Results
Ultimately, 107 patients were analyzed in the two groups (52 patients in the spontaneous healing group vs. 55 patients in the Gelfoam patch-treated group). The overall closure rate at the end of the 3 month follow-up period was 90.4% in the spontaneous healing group and 94.5% in the Gelfoam patch-treated group; the difference was not statistically significant (p > 0.05). However, the total average closure time was significantly different between the two groups (26.8 ± 9.1 days in the spontaneous healing group vs. 14.7 ± 9.1 days in the Gelfoam patch-treated group, p < 0.01). In addition, the closure rate was not significantly different between the spontaneous healing group and Gelfoam patch-treated group regardless of the perforation size. The closure time in the Gelfoam patch-treated group was significantly shorter than that in the spontaneous healing group regardless of the perforation size (small perforations: 7.1 ± 1.6 days vs. 12.6 ± 3.9, medium-sized perforations: 13.3 ± 2.2 days vs. 21.8 ± 4.2 days, and large perforations: 21.2 ± 4.7 days vs. 38.4 ± 5.7 days; p < 0.01).
Conclusion
In the regeneration of traumatic tympanic membrane perforations, Gelfoam patching not only plays a scaffolding role for epithelial migration, it also promotes edema and hyperplasia of granulation tissue at the edges of the perforation and accelerates eardrum healing.
Resumo
Introdução
Na última década, houve um uso crescente de placas biomateriais na regeneração de perfurações traumáticas da membrana timpânica. As principais vantagens das placas de biomateriais são restaurar provisoriamente a função fisiológica da orelha média, assim melhoram imediatamente os sintomas da orelha e atuam como um suporte para a migração do epitélio. No entanto, não se sabe se há efeitos clínicos adicionais na regeneração do tímpano em relação ao fragmento de material biológico.
Objetivo
Avaliar a resposta de cicatrização para diferentes padrões de reparo em perfurações de membrana timpânica traumáticas humanas por meio de observação endoscópica.
Método
Foram alocados 114 pacientes com perfurações de membrana timpânica traumáticas sequencialmente para dois grupos: o de cicatrização espontânea (n = 57) e o tratado com esponja de Gelfoam (n = 57). A velocidade de fechamento, o tempo de fechamento e a taxa de otorreia foram comparados entre os grupos aos três meses.
Resultados
Foram analisados 107 pacientes nos dois grupos (52 no de cicatrização espontânea e 55 no tratado com esponja de Gelfoam). A velocidade global de fechamento no final do período de seguimento de três meses foi de 90,4% no grupo de cicatrização espontânea e de 94,5% no grupo tratado com esponja de Gelfoam; a diferença não foi estatisticamente significativa (p > 0,05). No entanto, o tempo total médio de fechamento foi significativamente diferente entre os dois grupos (26,8 ± 9,1 dias no de cicatrização espontânea versus 14,7 ± 9,1 dias no tratado com esponja de Gelfoam, p < 0,01). Além disso, a velocidade de fechamento não foi significativamente diferente entre o grupo de cicatrização espontânea e o grupo tratado com esponja de Gelfoam, independentemente do tamanho da perfuração. O tempo de fechamento no grupo tratado com esponjas de Gelfoam foi significativamente menor do que no grupo de cicatrização espontânea, independentemente do tamanho da perfuração (pequenas perfurações: 7,1 ± 1,6 dias vs. 12,6 ± 3,9, perfurações de tamanho médio: 13,3 ± 2,2 dias vs. 21,8 ± 4,2 dias e grandes perfurações: 21,2 ± 4,7 dias vs. 38,4 ± 5,7 dias; p < 0,01).
Conclusão
Na regeneração de PMT traumáticas, a esponja de Gelfoam não só desempenha um papel de estrutura à migração epitelial, mas também promove edema e hiperplasia de tecido de granulação nas bordas da perfuração e acelera a cicatrização do tímpano.
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Histopathological comparison of bone healing effects of endonasal and percutaneous lateral osteotomy methods in rabbit rhinoplasty model
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Şahin Öğreden, Sedat Rüzgar, Hasan Deniz Tansuker, Ümit Taşkın, Yalçın Alimoğlu, Salih Aydın, Mehmet Faruk Oktay, Uğur İzol
Abstract
Introduction
Lateral osteotomy is mainly performed either endonasally or percutaneously in rhinoplasty which is a frequently performed operation for the correction of nasal deformities. Both techniques have both advantages and disadvantages relative to each other.
Objective
The aim of this study was to compare the histopathological effects of endonasal and percutaneous osteotomy techniques performed in rhinoplasty on bone healing and nasal stability in an experimental animal model.
Methods
Eight one year-old New Zealand white rabbits were included. Xylazine hydrocloride and intramuscular ketamine anesthesia were administered to the rabbits. Endonasal osteotomy (8 bones) was performed in Group 1 (n = 4), and percutaneous osteotomy (8 bones) in Group 2 (n = 4). One month later the rabbits were sacrificed. Bone healing of the rabbits was staged according to the bone healing score of Huddleston et al. In both groups, nasal bone integrity was assessed subjectively.
Results
In the percutaneous osteotomy group, Grade 1 bone healing was observed in two samples (25%), Grade 2 bone healing in two samples (25%), Grade 3 bone healing in four samples (50%). In the endonasal osteotomy group, Grade 1 bone healing was observed in 6 samples (75%) and Grade 2 bone healing was observed in 2 samples (25%). In the percutaneous group, fibrous tissue was observed in 2, predominantly fibrous tissue and a lesser amount of cartilage was observed in 2 and an equal amount of fibrous tissue and cartilage was observed in 4 samples. In the endonasal group, fibrous tissue was observed in 6 samples, and predominantly fibrous tissue with a lesser amount of cartilage was observed in 2 samples. In both groups, when manual force was applied to the nasal bones, subjectively the same resistance was observed.
Conclusion
Percutaneous lateral osteotomy technique was found to result in less bone and periost trauma and better bone healing compared to the endonasal osteotomy technique.
Resumo
Introdução
Nas rinoplastias, a osteotomia lateral é realizada principalmente por via endonasal ou percutânea para correção de deformidades nasais. Ambas as técnicas apresentam vantagens e desvantagens.
Objetivo
Comparar os efeitos histopatológicos sobre a cicatrização óssea e estabilidade nasal entre as técnicas de osteotomia endonasal e percutânea em rinoplastia em um modelo animal experimental.
Método
Foram incluídos oito coelhos brancos da Nova Zelândia de um ano de idade. Hidrocloreto de xilazina e cetamina intramuscular foram administrados aos coelhos como agentes anestésicos. Osteotomia endonasal (8 ossos) foi realizada no Grupo 1 (n = 4) e osteotomia percutânea (8 ossos) no Grupo 2 (n = 4). Um mês depois, os coelhos foram sacrificados. A cicatrização óssea dos coelhos foi avaliada de acordo com o escore de cicatrização óssea de Huddleston et al. Em ambos os grupos, a integridade do osso nasal foi avaliada subjetivamente.
Resultados
No grupo da osteotomia percutânea, observou-se cicatrização óssea de grau 1 em duas amostras (25%), cicatrização óssea de grau 2 em duas amostras (25%), e cicatrização óssea de grau 3 em quatro amostras (50%). No grupo da osteotomia endonasal, observou-se cicatrização óssea de grau 1 em 6 amostras (75%) e a cicatrização óssea de grau 2 foi observada em 2 amostras (25%). No grupo percutâneo, o tecido fibroso foi observado em 2 amostras, enquanto tecido predominantemente fibroso e uma menor quantidade de cartilagem foi observada em 2 e uma quantidade igual de tecido fibroso e cartilagem foi observada em 4 amostras. No grupo endonasal, observou-se tecido fibroso em 6 amostras e tecido predominantemente fibroso com uma menor quantidade de cartilagem em 2 amostras. Em ambos os grupos, quando força manual foi aplicada aos ossos nasais, a mesma resistência foi observada subjetivamente.
Conclusão
A técnica de osteotomia lateral percutânea resultou em menor traumatismo ósseo e periosteal e melhor cicatrização óssea em comparação com a técnica de osteotomia endonasal.
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Bacteriology of peritonsillar abscess: the changing trend and predisposing factors
Publication date: September–October 2018
Source: Brazilian Journal of Otorhinolaryngology, Volume 84, Issue 5
Author(s): Yi-Wen Tsai, Yu-Hsi Liu, Hsing-Hao Su
Abstract
Introduction
Peritonsillar abscess is the most common deep neck infection. The infectious microorganism may be different according to clinical factors.
Objective
To identify the major causative pathogen of peritonsillar abscess and investigate the relationship between the causative pathogen, host clinical factors, and hospitalization duration.
Methods
This retrospective study included 415 hospitalized patients diagnosed with peritonsillar abscess who were admitted to a tertiary medical center from June 1990 to June 2013. We collected data by chart review and analyzed variables such as demographic characteristics, underlying systemic disease, smoking, alcoholism, betel nut chewing, bacteriology, and hospitalization duration.
Results
A total of 168 patients had positive results for pathogen isolation. Streptococcus viridans (28.57%) and Klebsiella pneumoniae (23.21%) were the most common microorganisms identified through pus culturing. The isolation rate of anaerobes increased to 49.35% in the recent 6 years (p = 0.048). Common anaerobes were Prevotella and Fusobacterium spp. The identification of K. pneumoniae increased among elderly patients (age > 65 years) with an odds ratio (OR) of 2.76 (p = 0.03), and decreased in the hot season (mean temperature > 26 °C) (OR = 0.49, p = 0.04). No specific microorganism was associated with prolonged hospital stay.
Conclusion
The most common pathogen identified through pus culturing was S. viridans, followed by K. pneumoniae. The identification of anaerobes was shown to increase in recent years. The antibiotics initially selected should be effective against both aerobes and anaerobes. Bacterial identification may be associated with host clinical factors and environmental factors.
Resumo
Introdução
O Abscesso Peritonsilar é a infecção cervical profunda mais comum. O microrganismo infeccioso pode ser diferente de acordo com os fatores clínicos.
Objetivo
Identificar o principal agente causador do abscesso peritonsilar e investigar a relação entre o patógeno causador, os fatores clínicos do hospedeiro e a duração da hospitalização.
Método
Este estudo retrospectivo incluiu 415 pacientes hospitalizados diagnosticados com abscesso peritonsilar que foram internados em um centro médico terciário de junho de 1990 a junho de 2013. Coletamos dados através da análise dos arquivos médicos dos pacientes e analisamos variáveis como características demográficas, doença sistêmica subjacente, tabagismo, alcoolismo, hábito de mascar noz de betel, bacteriologia e duração da hospitalização.
Resultados
Um total de 168 pacientes apresentaram resultados positivos para isolamento de patógenos. Streptococcus viridans (28,57%) e Klebsiella pneumoniae (23,21%) foram os microrganismos mais comuns identificados pela cultura da secreção. A taxa de isolamento de anaeróbios aumentou para 49,35% nos últimos 6 anos (p = 0,048). Os anaeróbios comuns foram Prevotella e Fusobacterium spp. A identificação de K. pneumoniae aumentou em pacientes idosos (idade > 65 anos) com razão de chances (Odds Ratio - OR) de 2,76 (p = 0,03) e diminuiu na estação do calor (temperatura média > 26 °C) (OR = 0,49, p = 0,04). Nenhum microrganismo específico foi associado à hospitalização prolongada.
Conclusão
O patógeno mais comumente identificado através da cultura de secreção foi S. viridans, seguido por K. pneumoniae. A identificação de anaeróbios mostrou ter aumentado nos últimos anos. Os antibióticos selecionados inicialmente devem ser efetivos contra aeróbios e anaeróbios. A identificação bacteriana pode estar associada a fatores clínicos e fatores ambientais do hospedeiro.
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